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Dental disorders are associated with heart disease

Dental disorders are associated with heart disease

Last Reviewed : 01/07/2021
Dental disorders are associated with heart disease

  • Poor periodontal health has been positively correlated with cardiovascular disease (CVD). Several studies have shown that periodontal disease is associated with heart disease, however, it is not yet clear if poor periodontal health causes CVD. Scientists believe that inflammation caused by periodontal disease may be responsible for the association.

 

Cardiovascular diseases (CVD), including acute myocardial infarction and angina pectoris are most common medical problems in the general population. Annual mortality from CVD is about 12 million cases per year and are responsible for 30% of all deaths in the United States.

Gingivitis and Periodontitis are associated with extensive plaque and calculus deposits are most prevalent, extensive and severe in developing countries and in population with limited access to health education and dental care. Mild forms of periodontal disease (PD) affect 75% of adults in the United States, and more severe forms affect 20 to 30% of adults. Since PD is common in population, it may account for significant portion of proposed infection-associated risk for CVD.

Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. 

 

There are two plausible underlying causes that can explain the link between Periodontal disease and Cardiovascular disease:

 1. Periodontal disease (PD) may cause CVD

Periodontal microorganisms present in dental plaque appear in the bloodstream in direct proportion to the severity and extent of periodontal infection.They have been hypothesized to cause systemic inflammation, impair insulin action, increase glycogenesis in the liver, and alter gut microflora resulting in systemic inflammation and metabolic changes.

 Porphyromonas gingivalis counts are higher in sub-gingival plaque in periodontal disease, where it causes inflammation and periodontal destruction.The organism enters the bloodstream following tooth brushing, and has been found in the intima of distant blood vessels including in coronary arteries,where it proliferates, initiating an inflammatory cascade leading to apoptosis and consequent endothelial dysfunction, which is associated with hypertension. It can also cause atherosclerosis by stimulating foam cell production. Per some studies, P.gingivalis has been shown to increase low-density lipoprotein (LDL) and total cholesterol levels by up-regulation of a protein which impacts circulating levels of LDL cholesterol. 

2.  PD and CVD have some unmeasured common causes

 The unmeasured common cause could be an inadequately measured risk factors such as smoking or some combination of unmeasured genetic polymorphisms that predispose individuals to both PD and CVD.

 

In summary, evidence from observational data and epidemiologic studies suggests that a potential link does exist between PD and CVD. Prospective interventional studies are required to determine the exact link between PD and CVD as well as to evaluate whether periodontal treatment may reduce the risk of developing CVD. 

As the ongoing studies report and confirm the strength of the association between PD and CVD, in the next few years, the oral healthcare professionals and the medical professionals can prepare for better planning of prevention programs.

 

Source: American College of Cardiology, American Academy of Periodontology, National center for Biotechnology Information. 

For further reading,

American Academy of Periodontology, SUNSTAR Announce 2019 Innovation Grant Recipients

American Academy of Periodontology and American Dental Association Mourn the Loss of Robert J. Genco, DDS, PhD

Periodontal Disease Bacteria Linked to Alzheimer’s Disease

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